So, What Is a Demand Escalation Anyway?


Earlier this month BRHS began using its Facebook page to notify the community when our hospital is experiencing high activity levels. This is called a “Demand Escalation Alert.”

Our goal with these social media posts is to give people coming to the health service some idea of what to expect, and, if they are thinking of heading to the Emergency Dept., a reminder to consider other treatment options if their injury or illness is not too serious.

The post generated a lot of attention and shares.

So we thought we’d follow up with some more information about what a Demand Escalation situation is, what it actually means at the hospital, and how often they happen.

Demand Escalations are an evidence-based approach used by health services all over Australia.

Demand Escalations are not uncommon, particularly in recent years as the number of people presenting to the BRHS Emergency Department and being admitted as inpatients continues to rise.

Since the beginning of March this year there have been about 20 Demand Escalations called for the hospital.

They are called when certain trigger levels are reached, such as wait times for ambulances to admit patients, the number of people in the Emergency Department waiting room needing urgent attention, or the unavailability of beds in our inpatient wards.

Demand Escalations are a mechanism to focus staff attention and efforts on ensuring the right patients are in the right place for the care they need.

This often means reviewing, discharging or admitting patients. It can mean cleaning beds and calling loved ones to advise them that patients are ready to go home.

Additional staff resources are diverted to assist where required, and transfers or discharges are expedited if safe to do so to free up additional beds for people who cannot be cared for in the community.

Our partner health services in Gippsland are contacted to see if they have the capacity to receive patients.

This process is overseen managed on the floor by the Patient Services Coordinator and Clinical Operations Manager.

BRHS’ Clinical Operations Manager is Jo Marshall, and she said this week that the Demand Escalation process was designed to get all hands on deck during a period of high demand at the hospital.

“It allows us to apply an all-of-hospital approach to get patients the treatment they need quickly and safely, in the place that’s most appropriate for them,” Jo said. “The community certainly has a role to play by remembering that the Emergency Department is designed for people requiring emergency care for serious and life-threatening conditions. If that’s not you, we encourage you to seek appropriate medical care and keep our ED nurses and doctors free to treat those that urgently need them.”

For more information about the Emergency Dept., and other care options available in the area, visit